Objective To evaluate the change and clinical significance of serum procalcitonin(PCT)and C-reactive protein(CRP)in patients with septic shock. Methods Patients with severe infection in the intensive care unit (ICU) of a hospital between January 2013 and June 2015 were selected. According to the extent of infection,patients were divided into septic shock group (n= 66,subdivided into survival group [n= 50]and death group[n= 16]according to 1-month survival)and severe sepsis group (n= 62),control group were patients without septic shock during the same hospitalization period,serum PCT,CRP,and WBC levels in each group at different times before and after treatment were compared. Results In septic shock group,serum PCT,CRP and WBC levels before treatment,after 1,3,and 7 days of treatment were all significantly higher than control group;in severe septic shock group,serum PCT and CRP levels after 1 ,3 ,and 7 days of treatment were all significantly higher than control group;in death group,serum PCT levels after 1,3,and 7 days of treatment were all significantly higher than survival group,CRP levels after 3 and 7 days of treatment were both significantly higher than survival group(all P<0.05). Receiver op-erating characteristic (ROC)curves showed that area under the curve (AUC)and 95% CI of PCT,CRP,and WBC were 0.786(0.703-0.864),0.754(0.691-0.827),and 0.603(0.542-0.679)respectively. Spearman correlation analysis showed that serum PCT and CRP in patients with septic shock before treatment,after 7 days of treatment were positively correlated([r= 0.596,P= 0.004],[r= 0.523,P= 0.012],respectively),and after 7 days of treat-ment,serum PCT was positively correlated with WBC(r= 0.604,P= 0.001 ). Conclusion PCT can be used as a indicator in early diagnosis of patients with septic shock,and dynamic observation of PCT and CRP has important significance in evaluating patients'severity and prognosis.

Objective To investigate the clinical characteristics of children with refractory Mycoplasma pneumoniae pneumonia (RMPP),and to analyze the related risk factors. Methods Clinical manifestations,laboratory indexes and image features of 628 children with Mycoplasma pneumoniae pneumonia (MPP) from January 2012 to October 2016 were retrospectively analyzed, and stepwise logistic regression analysis was performed for risk factors of RMPP. ROC curve was mapped to analyze the predictive value of independent risk factors in RMPP. Results Compared with 486 cases of general Mycoplasma pneumoniae pneumonia (GMPP), 142 cases of refractory MPP was older, and durations of fever and hospitalization, azithromycin treatment days were longer, pulmonary complications, lesions in the right lobe and right upper lobe, pleural effusion, lobar atelectasis, pulmonary consolidations, and pleural thickening ratio were higher, the percentage of neutrophil, CRP, LDH, CK-MB, IL-6, IL-10, IFN-γ and IgA levels were also higher (all P<0.05). Stepwise logistic regression analysis showed that CRP, LDH, IL-6, IL-10, IFN-γ were the independent risk factors of RMPP. ROC curve analysis showed that CRP, LDH, IL-6, IL-10 and IFN-γ has a good value for identification of children with RMPP and GMPP, the best threshold value of 15.3 mg/L, 402 IU/L, 13.82 pg/mL, 5.07 pg/mL, and 13.84 pg/mL, respectively. Conclusions The clinical symptoms and imaging findings of the lung are severer,and the levels of serum CRP, LDH, IL-6, IL-10, and IFN-γ are significantly increased, which is helpful for the early identification of RMPP.

Objective To investigate the changes and clinical significance ot the expression ot microRNA in plasma and peripheral blood mononuclear cells in patients with schizophrenia.Methods 174 patients with schizophrenia in Danzhou People 's Hospital were selected as the case group and the other 80 healthy persons as control group The relative expression levels of 8 microRNA in two groups of plasma and pcripheral blood mononuclear cells were detected by real-time quantitative fluorescent PCR(MiR-195,MiR-346,MiR-181b,MiR-212,MiR-30e,MiR-432,MiR 7,MiR-34a),and the differences of microRNA in the plasma and peripheral blood mononuclear cells were compared between the two groups.ROC curve was used to analyze the sensitivity and specificity of microRNA as diagnostic criteria for schizophrenia and Logistic regression analysis of the relative risk of microRNA in schizophrenia.Results The expression levels of MiR-195,MiR-181b,MiR-132,MiR-30e,MiR-7 and in the patients of the case group(3.11±1.05,2.18±0.72,1.85±0.74 and 9.61±1.87) were significantly higher than those in the control group(4.48±1.07,2.92±0.86,3.53±1.07 and 11.96±2.73,P＜0.05 or P＜0.01).The expression levels of MiR-181b,MiR-212,MiR-30e and MiR-34a in peripheral blood mononuclear cells of patients in the case group (-4.20±1.16,0.27 ±0.55,-4.83± 1.05 and 2.64± 1.08) were significantly higher than those in control group (-3.56±0.81,0.91±0.68,-3.49±1.22 and 3.95±1.03,P＜0.05 or P＜0.01).Logistic regression analysis showed that plasma MiR-181b and MiR-30e were significantly relative risk (OR=2.357,95 ％ CI:1.361 ～ 4.093;OR=2.064,95 ％ CI:1.147～3.815),and peripheral blood mononuclear cells MiR-30e also had significant relative risk (OR=1.628,95 ％CI:0.914～2.926).ROC curve analysis showed that 95％CI and AUC in plasma and peripheral blood mononuclear cells of MiR-181b were 0.702 (0.784～0.632),0.658 (0.593 to 0.736),and plasma and peripheral blood mononuclear cell of MiR-30e were 0.775 (0.706～0.857),0.758 (0.686～0.839),respectively.Spearman correlation analysis showed that plasma MiR 181b and plasma MiR-30e were significantly correlated (r=0.547,P =0.043).Conclusion Abnormal expression of microRNA in patients with schizophrenia,and plasma and peripheral blood mononuclear cells MiR-181b and MiR-30e had good diagnostic value for schizophrenia patients.

Objective To evaluate the association between interleukin-10(IL-10 )polymorphisms and endometriosis suscepti-bility by meta-analysis.Methods Computer retrieval Pubmed,Embase,Chinese HowNet,Chinese biomedical and Wanfang database.Published data relating to case-control studies reporting the link between IL-10 polymorph-isms and endometriosis were retrieved.Meta-analysis was conducted to determine whether the IL-10 gene polymorphisms were associated with endo-metriosis.Results Six studies were finally accepted for analysis.There were five studies focused on-819T/C polymorphism and six studies focused on-592A/C polymorphism.The odds ratio of each genetype for endometriosis:TT/CC,TC/CC,AA/CC and AC/CC were 0.90(0.81~0.99),P<0.05;0.92(0.82~1.02),P>0.05;0.92(0.79~1.07),P>0.05;0.98(0.90~1.06),P>0.05.No significant publication bias was found regarding TT/CC,TC/CC,AA/CC and AC/CC genotypes(P=0.81,0.81,0.71,0.26).Conclusion IL-10 gene-819TT genotypes may be a protetive factor of endometriosis.There was no related to show that other genotypes in position-819 and-592 were associated with endometriosis.